2 Months to 4 Months

Feeding Baby

  • If baby is awake and unhappy/crying, first assume she is hungry. 
  • If baby seems full, put her down on her back to make sure. If she cries when this happens, offer more food. Never force the feed.
  • If baby refuses to eat and won’t stop crying, call the doctor.

How to increase your milk supply

  • Pump your breasts when they are empty. 5 minutes is sufficient.
  • Only pump the breasts immediately after a feed.

Spitting Up

  • All babies spit up; most of the time they swallow it down without you noticing. As long as baby is feeding well and stops crying when fed, this should be ignored.
  • Just a little spit up or what seems like the whole feed, 2 minutes or 2 hours after the feed, curdled or not curdled, this is normal as long as baby is feeding well and stops crying when fed. If baby won’t stop crying no matter what you do, call the doctor.
  • The frequency of spit-up increases between 2 and 6 months of life. This is also normal.
  • Babies do not suffocate on their spit up.

Development

  • Tummy time, all the time. If baby is awake and quiet, you should be doing tummy time on a firm, flat surface.
  • Babies need two things for development at this age:
    • Tummy time
    • Hearing words from the people they care about.

Milestone Goals for 4 Month Visit

  • The following assumes your baby was born on time.
  • If your baby was born early, you should base your expectations on her corrected age.
  • By 4 months, it's important that you've seen your baby roll from tummy time completely onto her back.
    • The only way to make this happen is tummy time, all the time.
    • If this hasn't happened by 4 months, we usually refer to physical therapy for extra help getting on track.
  • Puts hands in mouth
  • Smiles when you smile at her

Preventing Flat Head Syndrome

  • Some babies get flat heads, which may require a helmet to mold the head back to normal.
  • Tummy time whenever baby is awake and quiet.
  • No equipment (bouncers, swings, floor chairs, etc). These cause head flattening.
  • Alternate which arm you hold baby with.

Teething

  • Around 3 or 4 months of life, baby's find their hands and begin drooling a lot.
  • Parents sometimes think this means baby is teething.
  • In reality, these are just normal developmental milestones.
  • Most babies don't show teeth until at least 6 months of life.
  • A baby is not teething until you can feel teeth. Rub your finger along the gums and feel for sharp teeth breaking through.

Infant Sleep Patterns

  • Please see our guide to infant sleep in the first year of life for additional details.
  • Most brains start making melatonin around 8 weeks of life. This is the chemical that establishes our circadian rhythm and helps us sleep through the night.
  • At the 2 month visit, most parents are happy with how their baby is sleeping. If this is you, continue what you're doing. If it ain't broke, don't fix it.
  • If sometime between 2 and 4 months of life, your baby starts waking up every 1-2 hours throughout the night, I recommend doing four things.
    1. Always offer food first when this happens. The most likely reason is that she is hungry. If she eagerly finishes what you give her, offer more.
    2. Give her an early bedtime between 6-8pm, usually as close to 6pm as possible. Melatonin production peaks between 6-8pm, so putting her down for bed before this happens is the goal.
    3. Make the room so dark that you can't see your hands in front of your face. Sometimes this requires black trash bags over the windows. When any light enters the eye, it decreases melatonin production from the brain.
    4. Use a sound machine with white or brown noise. Don't use a timer. Make it run for the duration of overnight sleep.
  • Daytime naps occur at random until 3-4 months of life. At 2 months of life, you should not expect any pattern to the naps. As you approach 4 months of life, you can try the following:
    1. Make the room so dark that you can't see your hands in front of your face. Sometimes this requires black trash bags over the windows.
    2. Use a sound machine with white or brown noise. Don't use a timer. Make it run for the duration of overnight sleep.
    3. Put her down around 90 minutes after she wakes up in the morning and after each nap ends. This will ensure she is not overtired when you put her down. The goal is to put her down with a full tummy, in the perfect environment, and before she is overtired.